Organization Active NPI

Northern Calif Childrens Hematology & Oncology Med GRP Inc

  • Pediatric Hematology & Oncology Physician
  • Sacramento, CA
National Provider Identifier
1700943131
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
Legal business name
NORTHERN CALIF CHILDRENS HEMATOLOGY & ONCOLOGY MED GRP INC
Practice address
5030 J Street
Suite 200
Sacramento, CA 95819
Phone
(906) 469-9337
Fax
(209) 577-1509
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Yung Yim, MDNPI 1083701007
Title
President
Phone
(916) 469-9337

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0207X Primary

Addresses

Primary practice location

5030 J Street
Suite 200
Sacramento, CA 95819

Mailing address

PO Box 906
Salida, CA 95368
Phone (209) 577-9900

Other identifiers 1

IdentifierTypeStateIssuer
GR0062830MedicaidCA

National Provider Directory

National Provider Directory

Locations

4120 Prescott Rd
Modesto, CA 95356
Phone (209) 544-7300

5030 J St
Ste 200
Sacramento, CA 95819
Phone (916) 451-8001

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438560000000",
    "number": "1700943131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 906",
            "city": "SALIDA",
            "state": "CA",
            "postal_code": "95368",
            "telephone_number": "209-577-9900",
            "fax_number": "209-577-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 J STREET",
            "address_2": "SUITE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95819",
            "telephone_number": "906-469-9337",
            "fax_number": "209-577-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN CALIF CHILDRENS HEMATOLOGY & ONCOLOGY MED GRP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2015-08-03",
        "status": "A",
        "authorized_official_last_name": "YIM",
        "authorized_official_first_name": "YUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-469-9337",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0062830",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.